Active NPI
Marlene Sandstrom, PHD
- Clinical Psychologist
- Williamstown, MA
National Provider Identifier
1508486572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7679
- Practice address
- 11 Gale Rd
Williamstown, MA 01267-2806 - Phone
- (413) 884-5300
- NPI assigned
- Apr 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7679 | MA | Primary |
Addresses
Primary practice location
11 Gale Rd
Williamstown, MA 01267-2806
Mailing address
11 Gale Rd
Williamstown, MA 01267-2806
Phone (413) 884-5300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587340800000",
"number": "1508486572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 GALE RD",
"city": "WILLIAMSTOWN",
"state": "MA",
"postal_code": "012672806",
"telephone_number": "413-884-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 GALE RD",
"city": "WILLIAMSTOWN",
"state": "MA",
"postal_code": "012672806",
"telephone_number": "413-884-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDSTROM",
"first_name": "MARLENE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-20",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "7679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamstown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.